Introduction: Carotid body tumors are the most common paraganglionoma of the head and neck. Surgical resection is the recommended therapy as the natural history is continued growth and involvement of cranial nerves. Larger tumors are associated with arterial reconstruction and temporary or permanent cranial nerve injury. We present a video case of a large Shamblin III right carotid body tumor resection with preservation of the carotid arteries and cranial nerves. Patient History: A 27yo male initially diagnosed with a right carotid mass at the time of workup for right shoulder pain. Due to social issues, he never followed up, but was referred to our clinic in 2018 with enlargement of the mass. He was asymptomatic from the mass and workup included carotid duplex and computed tomography angiogram (CTA) of the head and neck. These studies revealed a Shamblin III right carotid body tumor. He was offered surgical resection with pre-operative coil embolization of the vascular supply given the large size of the tumor. Case: After undergoing successful coil embolization of the tumor, he was brought to the operating room and a transverse incision was made over the mass. Sub-platysmal flaps were created and the tumor mobilized off the critical structures and care taken not to injure any cranial nerves. The carotid arteries remained intact avoiding reconstruction or ligation. He tolerated the procedure well with only minimal dysphagia post-operatively that resolved in the peri-operative period. He was discharged home in stable condition on post-operative day four.